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THIRD YEAR REMEMBRANCE OF MY MUM, LATE MRS ESTHER OLUFUNMILAYO ADESOBA

Photo0654It is not unexpected that I annually pay a tribute to the woman who brought me to life, in commemoration of her painful demise.

It happened exactly three years ago, oh just like yesterday, when my sweet mum Esther Olufunmilayo Adesoba passed on to glory. We celebrate you mum! Why would we not celebrate you? We would be ungrateful if we forgot to thank you on this day for molding our lives in a way that makes us admirable to a lot of people around the world. We would be ungrateful if we failed to show to the world that you were our “source”. The few friends we have around the world see us as special because of the qualities you instilled in us- hard work, honesty, respect, and good character. We are proud of you, mum!

People ask me “who is your mentor?” “Who guides you?” How do you manage to find your path in this very confusing way of life?” I always told them “My parents did a good job”. You and dad are my mentors. No one else! I have visited a few countries, met great people but none of them can compare to you in my life. You taught me how to live a decent and proper life.

One thing I want to thank you for on this day is how you took care of me and my siblings during our undergraduate studies. You guided us in our social life. You instructed us on where to go and where not to go, and we obeyed. No wonder we have no regrets about our past lives.  This day, we mourn you and yet celebrate you because we are representing you well here on earth.

I can see that you are praying for me, my siblings and our dad. We are progressing, conquering our challenges, representing you around the world and making impact.

Mum, we miss you so much. How we wish you were here to take part in our successes.

Mum, sleep on till we meet again!

Olugbenga, Taiwo, Kenny, and Oluwadamilola.

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THE 26TH OUTBREAK OF THE EBOLA VIRUS DISEASE: WHY SO SPECIAL?

Adesoba Passport PhotoAs a young public health enthusiast, my literature review of ebola virus six years ago was interesting as I studied the zoonotic disease with keen curiosity. But the recent outbreak in West Africa brings more realism about how deadly the disease could be. As at the time of my study, there was no recorded case of the disease in Nigeria, not even in West Africa and so, there seemed not be a true experience of how an outbreak could feel. More so, that previous outbreaks happened when I was apparently too inexperienced to comprehend such a public health issue. This twenty-sixth outbreak of ebola began in Guinea in December 2013. It then spread to Liberia, Sierra Leone, Nigeria and Senegal.

The outbreak in West Africa which has been described as the largest in history is the first in Nigeria and the sub-region. Since they say first impression lasts long, this outbreak therefore will leave with us scars that cannot be forgotten in a hurry. The shocking mortality in Liberia, Guinea and Sierra Leone has been connected with gaps reported in the medical care, training of health staff, infection control, contact tracing, epidemiological surveillance, alert and referral systems, community education, and mobilization. The New York Times reports that “W.H.O. leaders have said the outbreak in West Africa could be stopped in six to nine months, but only if a “massive” global response, which is nowhere in sight, is carried out”.

In my reflections, I tried to identify why this outbreak in West Africa is unique.

Firstly, it has been described by the US CDC as the first Ebola epidemic the world has ever known- affecting multiple countries with its unprecedented mortality. One wonders why the international spread did not happen in previous outbreaks when public health strategies were probably not as robust as they are now. It may be as a result of the apparent increase in international travels since the earlier outbreaks especially in the ‘70s and ‘80s. Moreover, the affected countries did not prove to have strong preparedness for the disease; consequently, the impact has been so far devastating. It also seems that border checks were not properly observed by the affected countries. This may not be unconnected with the porous borders of the highly integrated West African countries which has proven to be very beneficial even in spite of this health challenge. This shows that West African countries need to even be more integrated so that they can be more supportive of one another in challenging times like this. Heretofore, nearly 3, 000 deaths have been recorded in West Africa since the outbreak started in December 2013.

Furthermore, misinformation and propagation of mythical information about ebola have resulted in very risky practices among the people of West Africa both the learned and unlearned. Usually, whenever a new disease emerges, correct information may be scanty and there is a high chance of the emergence and wide spread of myths based on cultural or religious beliefs that are capable of arm-twisting the intelligence even of literates who may not be familiar with such health issues. For example, when HIV had yet to be famous and correct information was scarce, there were lots of false stories that caused a surge of stigma. It was so bad that no one would want to exchange handshake with someone living with the virus. It was a similar experience with this ebola outbreak. Shortly after the ebola virus disease spread to Nigeria, information emerged that bathing with salt and water, and drinking same would prevent the disease. This mythical information further spread to other West African countries and unfortunately, some that did it in Nigeria could not live to tell the tale.

Another lesson we should learn is that a disease outbreak could spark a sense of insecurity and eventually lead to violence. This ebola outbreak will be remembered for the violence it caused among the affected population particularly in Guinea that led to the needless death of some gallant aid workers in the country. This stemmed from misinformation that these humanitarians were coming to spread the virus. This caused panic among the people. According to Reuters, “these deaths are believed to be the first resulting from resistance to international efforts to curb the outbreak in the region. Reports say many villagers have accused the health workers of spreading the disease”. Therefore, a smooth collaboration between health and security departments should be strengthened especially in this time of health crisis.

Similarly, the Jerusalem Post reports that “this outbreak led to the first ever UN emergency Security Council meeting called on health crisis and has been declared a threat to international peace and security”. The lethality of the ebola virus disease does not only affect international health but also by some means threatens international peace and security.

To confirm that Ebola Virus Disease  (EVD) is a threat to peace and security, it resulted in the declaration of curfew in Sierra Leone. Mostly curfew is associated with unrest or conflict situations, as a measure taken to stem down violence. This remarkable outbreak of the Ebola Virus Disease has received such an attention as startlingly, over one million people are under curfew and quarantined in Sierra Leone at this moment. The effect of the necessary curfew on the socio-economic lives of the people is undoubtedly huge.

As the control of the EVD outbreak in West Africa continues, more support is needed from the United Nations, international development partners and epidemiology experts; and all the lessons learnt should be properly kept to inform our decisions should there be any emergence of a similar but unwanted international health challenge in the future.

Taiwo Adesoba is a Microbiologist, Social Worker, Evaluation Professional and Public Health Worker from Nigeria.

Kindly follow him on twitter: @tai_soba

Email: oluwasesan@gmail.com

The Fight Againt Ebola Virus in Nigeria

Ebola PhotoWith the recent emergence of Ebola Virus Disease (EVD) in Nigeria, I feel compelled to share my sincere opinions about the disease and what our attitudes should look like. I understand that many of my friends know me to be a cervical cancer prevention advocate and may be wondering how I got to know about ebola virus. I am a Microbiologist by university education and I studied virology during my undergraduate studies.
Permit me to pay my condolences to the families who have lost their loved ones to the pandemic.
Ebola Virus is strange to Nigeria and many Nigerian medical workers including physicians, laboratorians, nurses are just fiercely empowering themselves with information about it. The outbreak caught many medical experts in the country unawares as they may have never encountered such cases before. Moreover, since it’s a fever, the initial symptoms such as sore throat, headaches and muscle pains are similar to other fevers such as malaria and typhoid that they deal with frequently, and can be confused with them initially. However, it should be noted that Ebola Virus Disease (also known as Ebola Haemorrhagic Fever) is not new in the field International Health. After the first outbreak occurred in Zaire (Now Democratic Republic of Congo) in 1976, there had been about twenty four other outbreaks. There are five species of ebola virus namely Zaire Ebola Virus (occurred first in Zaire, now Democratic Republic of Congo), Sudan Ebola Virus (Occurred in Sudan), Reston Ebola Virus (USA), Tai Forest Ebola Virus (Cote d’Ivoire), Bundibugyo Ebola Virus (Uganda). They were named after the geographical locations of the outbreaks. Ebola virus causes a severe haemorrhagic fever in humans and other primates.
According to the World Health Organization, “Ebola is introduced into the human population through close contact with the blood, secretions, organs or other body fluids of infected animals. In Africa, infection has been documented through handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelopes and porcupines found ill or dead or in the forest”. Further reports from the WHO says ebola spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs and bodily fluid of infected people, and indirect contact with environments contaminated with such fluids.
There are suggestions that male survivors may be able to transmit the disease via semen for nearly two months and that burial ceremonies in which mourners have direct contact with the body of the deceased person can play a role in the transmission of Ebola.
Nigeria seems to have an early warning system and preparedness for the disease. Apparently, this was why the Federal Ministry of Health (FMoH) swung into action immediately after the national index case was announced. Due to its fever symptoms, the disease probably deceived the staff of the clinic that attended to Mr Sawyer from Liberia who eventually died. It was a similar story in the first recorded case of Zaire Ebola Virus on 26 August 1976 when Mabalo Lokela, a 44-year old school teacher showed symptoms confused with Malaria. I am impressed at the good national response to the outbreak from the Nigerian government.
The Ebola Virus Disease seems to be a bit controllable as most of the previous outbreaks lasted for two months to less than a year. For example, Bundibugyo Ebola Virus outbreak started on November 24 2007 and the Ugandan Ministry officially announced an end to the epidemic on 20 February 2008, with the last infected person discharged on 8 January 2008. Likewise, an outbreak of Zaire Ebola Virus lasted from November to December 2003 (About 2 months). If efforts are intensified in Nigeria and other countries battling with the pandemic, it can be controlled early.
One concern I have is that staffs of Primary, Secondary and Tertiary Health Care facilities may require quick capacity building to make them aware of the disease and as well begin to adopt preventive practices such as barrier nursing. The Nigeria Medical Association should give guidelines about handling of fever-related cases such as adoption of barrier nursing at least for the next few months until the disease is declared controlled. In the outbreak of Sudan Ebola Virus of 1976, the lack of barrier nursing allegedly facilitated the spread of the virus and the disease.
The recent development has caused many to start spreading different unconfirmed and mythical reports. These reports are already influencing the behaviours of the general public, especially the greetings and what they eat. I like to shake hands and hug people but I was warned severely by a friend to stop doing that. Earlier, there was a report that bitter kola was an antidote to ebola virus infection but we are still waiting for stronger statements regarding this. I was not surprised to see that bitter kola was packaged differently by road-side sellers on my way to Lagos about two days ago (Aug 8 2014). You now find large quantities of the commodity at high prices. Expectedly, there are indications that the sale of bush meat is nose-diving as we know that animals such as bats and monkeys are reservoirs for the virus. Although many Nigerians enjoy eating bush meat, many have been discouraged from eating it. It is a good preventive measure but the Health ministry has yet to issue any statement regarding this. During Sudan Ebola Virus outbreak in 1976, the disease was believed to have broken out among cotton factory workers and the first case was believed to have been exposed to a natural reservoir. In response, many local animals and insects were tested but none was found to be carrying the virus. In this recent circumstance, the late Mr Sawyer from Liberia (index case) was not reported to have visited any forest in Nigeria and there has been no confirmed report of any hunter or forest worker coming down with the fever. Therefore, there is no official ban on the consumption of bush meat. However, abstinence from bush meat for this period may be sensible.
The WHO says no licensed vaccine for Ebola Virus Disease is available, although several vaccines are being tested. None is available for clinical use. No specific treatment is available too but new drugs are being evaluated.
The civil society should rise up to the occasion through awareness creation and proper information dissemination and helping to debunk emerging myths. The recent development has given opportunities for rumour-mongers to share unconfirmed reports via the social media. Some of the recent rumours were that the disease can be prevented by washing with warm salt solution; and drinking same. It is the responsibility of health-focused Civil Society Organizations to debunk these myths as well those that will soon emerge in their communities. It is worthy of note that some Nigeria telecommunication companies are really assisting by providing updates about the disease. They send unsolicited messages regarding preventive measures against ebola virus. The messages I’ve got on my phone were in English but there may be need to translate them to other local languages so that everyone (not only elites) will benefit from this support. Similarly, media organizations (Prints, Radio and Television) are providing updates about the disease. The people depend on them to provide us assist in create awareness, allay fears, and educate all Nigerians.
The disease may be prevented by reducing contact with infected animal, properly cooking meat before consumption, good hand-washing practices and barrier nursing, especially by medical workers. Also, fluids and tissues from people with the disease should be handled with special caution.
More information can be got from:
http://www.who.int/mediacentre/factsheets/fs103/en/

Cervical Cancer prevention: Let the developing countries learn fast from the developed countries

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Cervical Cancer tends to be viewed with different lenses in developed countries than developing countries. Many years ago, cervical cancer had high mortality rates in the developed countries. It was a health challenge but these countries confronted the challenge with determination and strong political will; and now they are on top of the situation. While it the word “cervical cancer” remains a threat to women in developing countries, it comes with less heartache in the developed countries due to the health systems and government’s response.

As a consequence of growing and ageing populations, developing countries are disproportionately affected by the increasing numbers of cervical cancer cases. More than 60% of the world’s total cases occur in Africa, Asia, and Central and South America, and these regions account for about 70% of the world’s cancer deaths, a situation that is made worse by the lack of early detection and access to treatment (World Cancer Report 2014).

Initially it was a menace in the developed countries but later it was brought under control through innovative prevention and control programmes. In fact, at present, cervical cancer is both preventable and very treatable.

Ironically, cervical cancer was expelled from the developed countries and as it was looking for a more convenient location, it chose developing countries. Developing countries have failed to borrow the ideas of the developed countries in tackling the health threat. The situation can be described as the developing countries refusing to learn from the developed countries since they are seriously harbouring it just like someone keeping fire under their cloth. I think it is iniquitous for cervical cancer to remain endemic in developing countries when it is preventable, detectable and treatable.

The developed countries were are recording huge successes because of health interventions such as vaccination, awareness, screening, good health facilities, etc.

The starting point is getting the information to the people. Not women alone but men too. Lack of the right information may cause one to make wrong decisions about their sexual health. Cervical cancer still sounds strange to some women in the developing countries and when you begin to enlighten them you can see on their faces that they are frightened because probably they engage in one or two of the risk factors.

Another important measure is early detection of cervical cancer through screening. Identifying cervical cancer in its early stage leads to improved diagnosis, less radical treatment, decreased mortality and lower health care costs. With the rising costs of healthcare in many developing countries, success in early detection may depend on the affordability of screening servcices Poverty is a barrier that must be addressed if any success will be achieved in early detection. The success will be greater if screening is made free of charge.

Thirdly, vaccination of girls (9-13 years) is a measure that should be given careful consideration in our fight against cervical cancer. Research has indicated that the HPV vaccine provides effective protection for at least 20 years. While HPV screening is a preventive measure that should be routinely practiced, HPV vaccination secures the future by offering protection from cancer-causing strains of HPV. Our future wives and mothers stand a chance of not dying of cervical cancer if they are vaccinated when they are still girls.

Although there are evidences that some African countries are implementing HPV Vaccination pilot projects and a very few already implementing vaccination programmes, it is very essential that the outcomes of these programmes are shared with other countries that have yet to take actions. Moreover, more commitments are required from these countries in fighting cervical cancer. If the developed countries are winning the battle, then we can quickly learn from them and do something about the challenge so that maternal deaths from cervical cancer will be reduced to zero. Let us unite to fight cervical cancer!

7th African Evaluation Association (AfrEA) International Conference 2014

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AfrEA conference is the foundation for promoting and advocating AfrEA’s “Made in Africa” approach to evaluation and support the culture of evaluation in Africa.

Conference Venue: Yaounde, Hilton Hotel, Cameroon

Date : Monday, March 03, 2014 – Friday, March 07, 2014

Click here for details.

Cancer and its Myths: Out of Africa

cancerawarenessOne of the definitions for myth in the Advanced Learner’s dictionary is “something that many people believe but that does not exist or is false”. But I found another interesting definition from google: “A myth is a traditional story, especially one concerning the early history of a people or explaining a natural or social phenomenon, and typically involving supernatural beings or events.” This appears to be the cancer situation in Africa. Traditional beliefs are defining cancer in Africa because cancer is just getting recognition in some African communities. The discoveries made about cancer over 100 years ago in the developed countries are just seeping into the rural parts of Africa, after all we are a developing continent. For example, while Cervical cancer is an “old thing” that has passed away in some developed communities; behold it is still “new”, (I mean very new) in some African communities. Many people have false information about cancer and many people are very sentimental about it as well, and these orientations are affecting early detection of cancers. Late detection has been a major problem in cancer control in many poor communities of the world and it is a bit peculiar to black people, even in the US. In this information age, it is very important to spread the correct information and shift from fable to fact, from superstition to reality from tale to truth and from theories to certainty.

You wonder how myths are spread? Myths spread when someone is able to convince another to believe their own false idea or opinion about a matter. Especially in Africa where we revere our traditional and religious leaders, myths can be easily spread through our leaders’ false beliefs. For example, some people mistake breast lump for “African Bullet” because of what they were told (myth). Consequently, they seek traditional healing for such a condition, but when the situation gets worse, they seek the proper medical attention and unfortunately, it might be too late. The spread of myth is also attributable to illiteracy. Illiterates do not have inquisitive minds and so they don’t ask questions because they are very impressionable giving preference to the first (at times wrong) impression. Myths are never supported by empirical facts so the myths about cancer too are just the false and unproven opinions of some people and they are able to influence others to believing them.

Two of the cancer myths in Africa are:

  1. There’s nothing I can do about cancer: Many see cancer as a death sentence after all they have witnessed the death of cancer patients. But that is not true. Evidences have shown that deaths from most cancers are linked to late presentation. Not that alone research shows that most cancers are treatable if detected early.
  2. I cannot have cancer because there’s no history of cancer in my family: Apparently, cancer has some genetic basis but it is not true that lack of traceable family history escapes one from cancer especially when they are not living health lifestyles. It is good that one does not have a family history of cancer, however, an unhealthy lifestyle of smoking, lack of exercise, over-exposure to sun and such like would not make good your escape.

You may be wondering if cancer myths have affected us in any way. The answer is yes. When we spread the wrong information, other people may take wrong steps by acting on such information and definitely the outcome may be really bad. For example, when you believe that breast cancer is a death sentence, you don’t seek help when you see the sign and the result is death. Meanwhile in societies where the right information prevails, there is a higher survival rate because right actions are taking with right information.

What is the way out? The way out is to spread the truth. An African proverb says if lie (Myth) travels ahead of truth for one thousand years, truth will catch up in a day. As cancer prevention activists, our role is to seek the truth and share it. But it takes effort to exchange myth with truth in the heart of an average African…(funny) because he may not identify the truth. So this requires concerted effort from traditional leaders, religious leaders, social workers and the media to reinforce the right message. Sophocles said “what people believe prevails against the truth”. So the challenge is to make people believe the truth so that we can move ahead. Kofi Anan said “Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family”. Let us empower Africa with knowledge and liberate her people through correct and consistent information, then we shall live in good health and progress speedily.

SLAVE TRADE: ABOLISHED OR REFURBISHED?

International Day for the Remembrance of the Slave Trade and Its Abolition

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I was never a student of history at high school or college but my career has made me to have a strange passion for history. History is very essential when addressing development issues because it helps you to understand the root cause (s) of a problem, previous solutions proffered and an insight into better solutions. I did not witness the slave trade era in Africa but I have read some reports about it. A slave is someone bound in servitude as the property of a person or household; or one who is abjectly subservient to a specified person or influence. Yes, it happened in Africa many years before independence. People were bought and sold just like commodities. One very important song my fore fathers (slaves) sang then was:

“Home my home(x2)

When shall I see my home?

When shall I see my native land

I will never forget my home”

What a song! Song of sorrow, despair, regret, bondage, heart break, grief, trouble, and sadness. Yes, these are the feelings that characterize slavery.

During the slave trade in Africa, “our fore fathers” sold our “fore fathers” maybe due to selfishness or self-aggrandizement or perhaps they were deceived; and the wonderful, agile, and diligent black race paid severely for it. Slavery led to many inequalities which are still being addressed today. This reminds me of a statement in George Orwell’s Animal Farm (Novel): “all animals are equal but some are more equal than the other”.  I imagined how difficult life was for my forefathers at that time especially in a strange land of slavery. It must be a very difficult time. I wondered why it happened.

Who was responsible?

The purpose of this write up is not to apportion blames but it is for all young Africans to learn from the mistakes of our fathers and never to repeat such. From the stories I heard, our fathers were responsible for the enslavement of their subjects and I believe they took responsibility for their actions. They decided to release their subjects to be used as slaves. They did not understand they were hurting themselves.

Why did the slave trade stop?

In my reflection, I thought that the beneficiaries of the slave trade systems did not want it to stop. Why will they want it to stop? Of course, they wanted it to continue because of the wealth they got from the business. In my imagination, a time came when the slaves themselves gathered enough temerity to confront their masters and to negotiate a way out. I also imagined the slaves coming together to develop possible solutions to their problem. I imagined them asking, if they would ever be free despite their thirst for freedom.” Can we ever be liberated?” they asked. “Who will speak for us?” “Will that spokesperson not be killed?” And such like. But finally a day came when the slaves decided to completely face the challenge irrespective of what the outcome would be. All they wanted was freedom. The slave trade did not end until the term “Human Rights” began to filter into the social system. As knowledge advanced, people began to understand that “all animals are equal and none was more equal than the other”.  This led to various advocacies by the posterity of the slaves. They said “Our fathers were enslaved and they died as slaves but we will not die as slaves.” That led to increased awareness about equity, fairness, human dignity and justice.

One would think that slavery has ended but I think that it ended for a while then it re-emerged in a new dimension –“sexual slavery”. Sexual slavery is particular form of enslavement which includes limitations on one’s autonomy, freedom of movement and power to decide matters relating to one’s sexual activity. Thus, the crime also includes forced marriages, domestic servitude or other forced labour that ultimately involves forced sexual activity. In Nigeria for example, there have been cases of sexual slavery where Nigerian girls are trafficked abroad and used as sex slaves while their captors make money. What makes this crime more notable is the fact that just like our forefathers sold our forefathers, so it is today that people of the same race, tribe and religion lure innocent young girls of their own race, tribe and religion into sexual slavery. Sex slavery, including child marriage cannot continue, it must be resisted. We cannot wait to see our young girls trafficked to other countries where they become sex slaves. This affliction must not be allowed to stay for the second time. We do not also want our very innocent girls become child brides.

With the advancement of human rights particularly gender human rights, I call on governments of developing countries to entrench gender human rights instruments such as the Convention to Eliminate All Forms of Discrimination Against Women  (CEDAW),  Beijing Declaration (1995) and such like and put in place severe penalties for violators of gender human rights.

Finally, I want all young Africans to join in the fight against sex slavery and girl child trafficking in their communities, provinces/states and countries.

God bless Africa.

Happy International Day for the Remembrance of the Slave Trade and Its  Abolition.

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